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Chemosphere. 2019 Jul;226:321-328. doi: 10.1016/j.chemosphere.2019.03.171. Epub 2019 Mar 27.

Association of plasma and urine metals levels with kidney function: A population-based cross-sectional study in China.

Author information

1
Department of Occupational and Environmental Health, Xiangya School of Public Health, Central South University, Changsha, China; Key Laboratory of Hunan Province for Water Environment and Agriculture Product Safety, Central South University, Changsha. 410083, China.
2
Department of Occupational and Environmental Health, Xiangya School of Public Health, Central South University, Changsha, China.
3
Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China; Hunan Engineering Research Center of Skin Health and Disease, Central South University, Changsha, China; Hunan Key Laboratory of Skin Cancer and Psoriasis, Central South University, Changsha, China.
4
Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China.
5
Center of Clinical Pharmacology, The Third Xiangya Hospital, Central South University, Changsha, China.
6
Department of Environmental and Occupational Health, Tongji School of Public Health, Huazhong University of Science and Technology, Wuhan, China.
7
Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China; Hunan Engineering Research Center of Skin Health and Disease, Central South University, Changsha, China; Hunan Key Laboratory of Skin Cancer and Psoriasis, Central South University, Changsha, China. Electronic address: shenmx1988@csu.edu.cn.
8
Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China; Hunan Engineering Research Center of Skin Health and Disease, Central South University, Changsha, China; Hunan Key Laboratory of Skin Cancer and Psoriasis, Central South University, Changsha, China. Electronic address: chenxiangck@126.com.

Abstract

OBJECTIVES:

Although environmental exposure to multiple metals is common, epidemiological studies on the associations of exposure to 23 metals with kidney function have not been analyzed. We aimed to investigate the associations of 23 metals levels with renal function.

METHODS:

We conducted a cross-sectional study in four rural regions of Hunan province. Plasma and urine metals levels were determined by inductively coupled plasma mass spectrometer (ICP-MS). Two-level logistic regression was used to investigate the associations of metals levels with estimated glomerular filtration rate (eGFR) with adjustment for confounding factors. We conducted a sensitivity analysis of the results using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation.

RESULTS:

A total of 3553 participants completed the investigation. Five metals (plasma arsenic and molybdenum; urine copper, rubidium, and strontium) were identified to be significantly associated with renal function. Participants in the highest quartile of plasma arsenic and molybdenum were at 17.95 (95% CI: 6.35-50.76) and 24.23 (95% CI: 7.42-79.19) fold risk of abnormal eGFR, respectively, compared with the lowest quartile. The highest quartiles of urine copper, rubidium, and strontium were associated with 3.70 (95% CI:1.92-7.14), 0.16 (95% CI:0.07-0.37) and 0.08 (95% CI: 0.03-0.21) fold risk of abnormal eGFR. The sensitivity analysis revealed that plasma arsenic, molybdenum and urine copper, rubidium and strontium levels retained similar associations with abnormal eGFR.

CONCLUSION:

Plasma arsenic and molybdenum, and urine copper are risk factors for abnormal renal function, while urine rubidium and strontium are protective factors for renal function.

KEYWORDS:

CKD; CKD-EPI; MDRD; Multiple metals; eGFR

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